A client on a mental health unit develops flu-like symptoms and low blood pressure. After reviewing the client's history, it was noted that the client has a diagnosis of schizophrenia and is currently taking risperidone (Risperdal). The nurse should recognize that which of the following adverse effects may be occurring?
Neuroleptic malignant syndrome.
Tardive dyskinesia.
Acute dystonia.
Pseudoparkinsonism.
The Correct Answer is A
Choice A rationale:
Neuroleptic malignant syndrome (NMS) is a potentially life-threatening condition that can occur as a severe adverse effect of antipsychotic medications, such as risperidone (Risperdal). Symptoms of NMS include flu-like symptoms (fever, muscle rigidity, and sweating) along with altered mental status, and autonomic dysregulation. It's crucial for the nurse to recognize this potentially fatal condition promptly and intervene appropriately.
Choice B rationale:
Tardive dyskinesia is a movement disorder that is often a result of long-term use of antipsychotic medications, but it is characterized by repetitive, involuntary movements of the face and other body parts. It doesn't typically present with flu-like symptoms or low blood pressure.
Choice C rationale:
Acute dystonia is characterized by involuntary muscle contractions and spasms, often involving the muscles of the face, neck, and back. It usually occurs shortly after starting antipsychotic treatment. While it can cause discomfort, it doesn't present with flu-like symptoms and low blood pressure as described in the scenario.
Choice D rationale:
Pseudoparkinsonism, also known as drug-induced parkinsonism, is characterized by symptoms similar to Parkinson's disease, such as tremors, bradykinesia (slowness of movement), and rigidity. It doesn't typically cause flu-like symptoms and low blood pressure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Reality orientation is a technique commonly used in dementia care to help individuals be aware of time, place, and person. It is not directly related to the statement made by the client in the scenario about loving the daughter as much as the son based on academic performance.
Choice B rationale:
The correct choice. According to Eric Berne's theory of Transactional Analysis and Eric Erikson's psychosocial development stages, unconditional love is essential for fostering a positive sense of self-esteem. The statement made by the client to the daughter, linking love with better school performance, creates conditional love, implying that the daughter's worthiness of love is tied to her academic achievements. This can hinder the development of positive self-esteem.
Choice C rationale:
A sense of survival refers to basic human instincts related to self-preservation. It is not directly connected to the client's statement or the development of positive self-esteem in the context of parenting.
Choice D rationale:
A sense of responsibility involves understanding and fulfilling one's obligations. While it is important for parenting, the client's statement is more closely related to the concept of conditional love, which directly impacts self-esteem, as explained in choice B.
Correct Answer is D
Explanation
Choice A rationale:
Establishing trust with a caregiver in just five days is a challenging and unrealistic expectation for a child diagnosed with autistic spectrum disorder (ASD). Building trust takes time, especially for individuals with ASD who may struggle with social interactions and forming connections.
Choice B rationale:
Participating in a team sport with peers by day 4 might be too ambitious for a child with ASD. Children with ASD often require gradual exposure and support to engage in social activities, and such rapid participation might lead to anxiety and discomfort.
Choice C rationale:
While communication goals are important for children with ASD, expecting them to communicate all needs verbally by discharge might not be realistic. Many children with ASD use alternative forms of communication, such as gestures or assistive devices, which should also be considered as valid modes of expression.
Choice D rationale:
The realistic outcome for a child diagnosed with ASD is that they will perform most self-care tasks independently. ASD often affects social and communication skills, but children can learn and develop the ability to manage self-care tasks with proper support and intervention. This outcome aligns with the developmental trajectory of children with ASD.
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